Delayed sleep phase syndrome (DSPS)

Overview

Delayed sleep phase syndrome, often referred to as delayed sleep–wake phase sleep disorder, is a type of circadian rhythm sleep disorder. It occurs when an individual’s natural sleep pattern deviates from the conventional sleep pattern by a margin of two or more hours. This leads to bedtime and waking times that are significantly later, potentially causing disruptions in daily activities like work or school. 

It’s important to note that delayed sleep phase syndrome should not be confused with individuals who simply have a preference for staying up late, often called “night owls.” Night owls may choose to stay awake for various reasons like completing tasks or socializing, but they can still adjust to a conventional sleep schedule when required.

Symptoms

The inability to fall asleep at the conventional bedtime. As a result, getting up early becomes difficult, and the insufficient amount of sleep that results in multiple associated conditions.

• Having problem falling asleep: People with delayed sleep phase syndrome frequently struggle to fall asleep at their regular bedtime. A delay in your internal clock signals your body to remain awake and alert.

They frequently have trouble falling asleep until far after midnight, usually between 2 and 6 in the morning. Their sleep issues may get worse if they try to stay up for social or academic reasons.

• Having problem waking up: DSPS makes it difficult to wake up at a regular time due to the difficulty falling asleep until a late hour. This is due to the fact that their body’s internal clock hasn’t yet sent a wake–up signal. As a result, people with DSPS may sleep until the late morning or even into the afternoon.
• Excessive daytime sleepiness: DSPS makes it difficult for the person to fall asleep, but they are forced to wake up at set intervals. As a result, they could have trouble focusing and paying attention during the day. Even if they are able to go to bed early, DSPS can prevent them from getting enough deep sleep, which can lead to excessive daytime sleepiness.
• No other sleep issues: The condition typically does not co–occur with other sleep disorders such sleep apnea. If it doesn’t disrupt your daily routines, you are likely receiving sufficient, high–quality sleep; it’s simply delayed. Furthermore, people often have no trouble staying asleep throughout the night after they’ve been able to fall asleep.
• Depression and behavior problems: Failure to maintain a regular sleep schedule can potentially lead to depression caused by increased stress. Daytime drowsiness can further disrupt work or school commitments, resulting in tardiness, absenteeism, and difficulties in staying attentive.

Children and adolescents dealing with DSPS may encounter challenges in their academic performance. 

DSPS can contribute to the dependencies on substances like caffeine, alcohol, or sedatives as individuals seek ways to cope with their sleep–related issues.

Causes

The precise cause of delayed sleep phase syndrome remains elusive, yet it is often associated with several contributing factors, including:

• Genetics: A person’s chance of getting DSPS increases if they have a close relative who has the disorder. Approximately 40% of people with DSPS have a family history of the condition.
• Puberty: The 24–hour sleep cycle of the body lengthens during adolescence, requiring later sleep and wake hours. Additionally, adolescents frequently develop their social skills and increase their responsibility.
• Psychological and neurological disorders: DSPS is associated with various conditions, including depression, anxiety, attention deficit hyperactivity disorder (ADHD), and obsessive–compulsive disorder (OCD). 
• Chronic insomnia: About 10% of people with chronic insomnia are affected by DSPS.
• Poor sleeping habits: DSPS symptoms can get worse if people don’t get enough morning light. Additionally, excessive exposure to light at night can also contribute to an exacerbation of symptoms.